The present invention relates to a distractor, in particular a pediatric internal mandibular distractor for distracting bone surfaces.
The obstruction of the airway due to micrognathia is a frequent complication in infants and young children with congenital craniofacial syndromes such as Nager syndrome, Treacher Collins syndrome, and Goldenhar syndrome. These syndromes, along with specific secondary conditions such as maxillary hypoplasia in the setting of cleft lip and palate, hemifacial, microsomia, and Pierre Robin sequence, may require mandibular distraction. The small mandible causes prolapse of the tongue base against the posterior pharyngeal wall leading to respiratory distress. Particularly in young infants, airway obstruction is also commonly associated with feeding difficulties resulting in failure to thrive.
Mandibular distraction osteogenesis provides an alternative to traditional methods of airway management in infants with Pierre Robin Sequence. This approach consists of lengthening of the mandible, which allows the tongue base to move forward by its anterior muscular attachments to the mandible. Furthermore, this approach has allowed avoidance of tracheostomy as well as early decanulation in infants with Pierre Robin sequence. Tracheostomy in neonates is associated with perioperative and postoperative morbidity such as hemorrhage, pneumothorax, and tracheal stenosis.